Metabolic Biochemistry Warmup Questions

Day 3

1. Autopsy of a 61-year-old homeless male who died in the ER

shows foci of hemorrhage and necrosis in the mamillary bodies
and the gray matter surrounding the third and forth ventricles.
This patients condition could have been diagnosed early by
measuring which of the following?
A.
B.
C.
D.
E.

Erythrocyte transketolase activity

Erythrocyte glutathione reductase activity
Erythrocyte glucose-6-phosphate dehydrogenase activity
Serum NAD+ level
Serum methylmalonic acid level

2. A 3-year-old boy whose parents did not immunize him due to

fears of post-immunization side effects, exhibited fever, chills,
severe sore throat, lethargy, trouble breathing and a husky voice.
Physical exam indicated greatly enlarged lymph nodes, an
increased heart rate, and swelling of the palate. A picture of the
boys throat is shown in the attached figure to this question. A
diagnosis of diphtheria toxin poisoning was made. A necessary
cofactor or substrate used by the Diphtheria toxin in a reaction for
allowing these symptoms to appear in the child is which of the
following?
A.
B.
C.
D.
E.

ATP
NAD+
FAD
Acetyl-CoA
UDP-glucose

3. Laboratory animals deprived of folic acid experience a

marked increase in marrow erythroid precursor cell production.
Subsequently, many of these erythroid precursor cells undergo
apoptosis without further maturation. Provision of which of the
following supplements would reduce erythroid precursor cell
apoptosis in these animals?
A.
B.
C.
D.
E.

Homocysteine
Cysteine
Cytosine
Thymidine
Cobalamin

4. A 63-year-old man who is an alcoholic is brought into the

emergency department by his daughter. She states that the
patients memory has been very poor, and he constantly creates
elaborate yet untrue stories. Physical examination reveals ataxia
and bilateral horizontal nystagmus. Wernicke-Korsakoff syndrome,
caused by a water-soluble vitamin deficiency, is suspected. Which
of the following conditions is also a result of a water-soluble
vitamin deficiency?

A.
B.
C.
D.
E.

Increased erythrocyte hemolysis

Neonatal hemorrhage
Night blindness
Osteomalacia
Pellagra

5. A 28-year-old female presents

withfluctuating fatigue, drooping of
her eyelids, difficulty swallowing, and
slurred speech. The patient is given
a drug that affects the enzymes activity
and kinetic analysis of the enzymecatalyzed reaction, in the presence and
absence of the drug, is shown to the
right. The effect of this medication can
best be described by which set of terms below?
Inhibition
A. Competitive

Effect on Km
Increased

Effect on Vmax
No change

B. Competitive
Decreased
C. Noncompetitive Increased

Decreased
No change

D. Noncompetitive Decreased
E. Irreversible
Increased

Increased
No change

Answers
1) A
2) B
3) D
4) E
5) A